Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 6;22(1):225.
doi: 10.1186/s12879-022-07206-8.

Neutrophil-to-lymphocyte ratio is associated with 28-day mortality in patients with severe fever with thrombocytopenia syndrome

Yun Liu #  1 , Jun Ni #  2 , Yali Xiong #  3 , Chao Wu  4 , Fei He  5
Affiliations

Neutrophil-to-lymphocyte ratio is associated with 28-day mortality in patients with severe fever with thrombocytopenia syndrome

Yun Liu et al. BMC Infect Dis. .

Abstract

Objectives: To determine the association of the neutrophil-to-lymphocyte ratio (NLR) with 28-day mortality in patients with severe fever with thrombocytopenia syndrome (SFTS).

Methods: A single-centre retrospective analysis was performed in an emergency department from January 01, 2018, to June 30, 2021. Univariate and multivariable Cox proportional hazards regression models were used to investigate the prognostic factors associated with 28-day mortality. Kaplan-Meier curves were analysed in patients stratified by the optimal cut-off point of the NLR determined using a receiver operating characteristic (ROC) curve.

Results: In total, 182 SFTS patients were included, and 24 (13.2%) died within 28 days. The median age of the included patients was 59.64 ± 12.74 years, and 48.4% (88/182) were male. The patients in the non-survival group had significantly higher NLRs than those in the survival group (6.91 ± 6.73 vs. 2.23 ± 1.83). The NLR was a significant predictor of 28-day mortality (adjusted HR: 1.121, 95% CI: 1.033, 1.215). The area under the ROC curve of the NLR for predicting 28-day mortality was 0.743 (95% CI: 0.624, 0.862), and the optimal cut-off value was 4.19 (sensitivity, 54.2%; specificity, 89.2%). In addition, 28-day mortality in the patients with an NLR ≥ 4.19 was notably higher than that in the patients with an NLR < 4.19 (43.3% vs. 7.2%), and Kaplan-Meier analysis showed that the patients with an NLR ≥ 4.19 had a significantly lower survival rate than those with an NLR < 4.19.

Conclusions: The NLR was a significant, independent predictor of 28-day mortality in SFTS patients.

Keywords: Mortality; Neutrophil-to-lymphocyte ratio; Severe fever with thrombocytopenia syndrome.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig. 1
Fig. 1
Flow chart of the study participants
Fig. 2
Fig. 2
Comparison of the WBC count, ANC, ALC and NLR between the survival and non-survival groups (*P < 0.05). ANC absolute neutrophil count, ALC absolute lymphocyte count, NLR neutrophil-to-lymphocyte ratio, WBC white blood cell
Fig. 3
Fig. 3
Changes in the mean (± SE) NLR over 14 days in patients in the survival and non-survival groups. SE standard error, NLR neutrophil-to-lymphocyte ratio
Fig. 4
Fig. 4
ROC curve analysis of the WBC count, ANC and NLR for 28-day mortality in SFTS patients. ANC, absolute neutrophil count; NLR, neutrophil-to-lymphocyte ratio; ROC, receiver operating characteristic; SFTS, severe fever with thrombocytopenia syndrome; WBC, white blood cell
Fig. 5
Fig. 5
Kaplan–Meier survival curve of 28-day mortality according to the optimal cut-off of NLR = 4.19
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Seo JW, Kim D, Yun N, Kim DM. Clinical update of severe fever with thrombocytopenia syndrome. Viruses. 2021;13(7):1213. doi: 10.3390/v13071213. - DOI - PMC - PubMed
    1. Casel MA, Park SJ, Choi YK. Severe fever with thrombocytopenia syndrome virus: emerging novel phlebovirus and their control strategy. Exp Mol Med. 2021;53(5):713–22. doi: 10.1038/s12276-021-00610-1. - DOI - PMC - PubMed
    1. Wang L, Zou Z, Hou C, Liu X, Jiang F, Yu H. Score risk model for predicting severe fever with thrombocytopenia syndrome mortality. BMC Infect Dis. 2017;17(1):42. doi: 10.1186/s12879-016-2111-0. - DOI - PMC - PubMed
    1. Jia B, Yan X, Chen Y, Wang G, Liu Y, Xu B, et al. A scoring model for predicting prognosis of patients with severe fever with thrombocytopenia syndrome. PLoS Negl Trop Dis. 2017;11(9):e0005909. doi: 10.1371/journal.pntd.0005909. - DOI - PMC - PubMed
    1. Song M, Graubard BI, Rabkin CS, Engels EA. Neutrophil-to-lymphocyte ratio and mortality in the United States general population. Sci Rep. 2021;11(1):464. doi: 10.1038/s41598-020-79431-7. - DOI - PMC - PubMed

LinkOut - more resources